This study reports the course of diabetic retinopathy in 25 patients (41 eyes, 9 one-eyed patients) who had undergone successful renal and pancreatic transplantation. The mean duration of follow-up was 38 months (range, 15-71 months). Visual acuity improved in 13 eyes (32%), remained stable in 19 (46%) and deteriorated in 9 (22%); only 2 of the latter 9 eyes (5%) sustained severe visual loss according to the definition of the Diabetic Retinopathy Study Group. The frequency and severity of vitreous hemorrhage improved in 19 eyes (46%), remained unchanged in 18 (44%) and worsened in 4 (10%). In comparison with other modes of treatment such as intensified conventional insulin therapy and artificial insulin-delivery systems, the combined renal and pancreatic transplantation seems to have advantages concerning the course of proliferative diabetic retinopathy.